With minimal supervision, creates new accounts or modifications to existing accounts. Works membership related issues. Monitors receipt of expected membership files and runs load jobs. Establishes and maintains effective and collaborative relationships with clients and vendor. Monitors and ensures performance standards and guarantees are met.
Participates with implementation teams to set up eligibility for new accounts.
Leads the Eligibility work effort with the client and the vendor through development to production.
Coordinates with IT and vendor to define file layout and mapping requirements.
Coordinates configuration changes or addition of business lines to existing accounts.
Monitors receipt of expected membership files, notify client and account management of delayed files.
Builds and fosters client relationship.
Runs membership load jobs. Researches issues for root cause.
Leads the effort with client and/or vendor to resolve all issues.
Responsible for initial Setup and ongoing maintenance of Eligibility setup / configuration.
Provides reporting to Management on a monthly and quarterly basis activity against documented standards and performance guarantees.
Identifies client data trends and acts as consultant to client to improve quality of data and the member experience.
Other Job Requirements
Responsibilities
Minimum of 2 years of customer service, claims, or general office experience.Proficient with MS Office software.Ability to type 60 WPM.Strong ten key user.Results and solution oriented; not afraid to ask questionsProficient in Microsoft Office Suite, with primary focus being MS Excel and MS Access.
General Job Information
Title
Eligibility Processor
Grade
17
Work Experience - Required
Claims, Customer Service
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
License and Certifications - Required
License and Certifications - Preferred
Salary Range
Salary Minimum:
$31,175
Salary Maximum:
$46,765
This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Note: For Union-represented and Service Contract Act (SCA) positions, wage rates are governed by applicable bargaining agreement provisions or the defined SCA contract provisions.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.
Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.
Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .
Warning: Employment Scam
It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.
Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.
If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911
